Am Fam Physician. 2008 Jun 1;77(11):1534.
Are low glycemic index or low glycemic load diets effective in the treatment of obesity?
Compared with high glycemic index diets or conventional energy-restricted weight loss diets, low glycemic index diets better reduce body mass index (BMI) and low-density lipoprotein (LDL) cholesterol. The weighted mean difference showed that patients lost an additional 1 to 2 BMI units on the low glycemic index diets.
There are a number of treatments for obesity that have been proven effective, especially over the short term. Behavior and cognitive behavior therapy are effective, especially when combined with diet and exercise.1 Surgery results in greater weight loss than conventional treatments and improves quality of life, hypertension, and diabetes. However, it has a significant risk for morbidity and mortality.2 There is some evidence that anti-obesity agents such as orlistat (Xenical) and sibutramine (Meridia) promote weight loss, but studies have had methodological problems.3 Exercise and diet are effective. Exercise improves cardiovascular disease risk factors even when participants do not lose weight.4 Fat-control and calorie-control diets achieve weight loss.5
In this review, low glycemic index diets have been shown to be more effective than low-calorie or higher glycemic index diets. The authors found six randomized controlled trails (N = 202). Study interventions were at least five weeks. The longest studies had a six-month intervention with a six-month follow-up. No studies reported on adverse effects, mortality, or quality of life. Compared with other diets, low glycemic index diets resulted in statistically and clinically significant reductions in BMI, LDL cholesterol, and total fat mass. There was a reduction in insulin resistance, but not fasting morning insulin. Longer-term studies on treatment for obesity are needed.
Author disclosure: Nothing to disclose.
Thomas DE, Elliott EJ, Baur L. Low glycaemic index or low glycaemic load diets for overweight and obesity. Cochrane Database Syst Rev. 2007;(3):CD005105.
1. Shaw K, O'Rourke P, Del Mar C, Kenardy J. Psychological interventions for overweight or obesity. Cochrane Database Syst Rev. 2005;(2):CD003818.
2. Colquitt J, Clegg A, Loveman E, Royle P, Sidhu MK. Surgery for morbid obesity. Cochrane Database Syst Rev. 2005;(4):CD003641.
3. Padwal R, Li SK, Lau DC. Long-term pharmacotherapy for obesity and overweight. Cochrane Database Syst Rev. 2003;(4):CD004094.
4. Shaw K, Gennat H, O'Rourke P, Del Mar C. Exercise for overweight or obesity. Cochrane Database Syst Rev. 2006;(4):CD003817.
5. Pirozzo S, Summerbell C, Cameron C, Glasziou P. Advice on low-fat diets for obesity. Cochrane Database Syst Rev. 2002;(2):CD003640.
Copyright © 2008 by the American Academy of Family Physicians.
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